Via Teleconference 

10:33 A.M. EDT
ACTING ADMINISTRATOR SLAVITT:  Good morning. Thank you for joining us.
Yesterday afternoon, President Biden delivered a report to the nation on the progress of our vaccination program and our fight against this pandemic.
As the President communicated, our job is to bring the public the truth — both the good news and the bad news.  And we’re in a period when there’s a fair amount of both.  We’re making real progress even amidst continued challenges. 
First, there’s good news to report: The President announced yesterday that all adult Americans will be eligible to be vaccinated by April 19.  This is ahead of the original May 1st timeline that he set about — that he set last month.  So this means that there is no better time for seniors who haven’t been vaccinated to get their shot now. 
At this point, over 76 percent of seniors have had at least their first shot.  If you know a senior who has not yet had the opportunity to get a shot, consider helping them arrange that opportunity and see what help they need.  A number of seniors live alone and may need transportation or other help.  The good news is there are more and more locations in more places available for them.
President Biden also announced that we crossed 150 million shots in just 75 days of his administration.
We also have progress to report in our effort to open schools safely.  At the beginning of March, the President directed states and the Federal Retail Pharmacy Program to prioritize the vaccination of teachers, school staff, and childcare workers during the month of March. 
As the President announced yesterday, as of the end of March, the latest CD esti- — CDC estimates show that almost 80 percent of pre-K through 12th grade teachers, school staff, and childcare workers received at least one shot. 
And today, the Department of Education released the latest round of data from its own ongoing survey on the impact of COVID-19 on K through 8th grade students and the state of school reopening in the nation. 
This is encouraging early data — covering the month of February — and shows progress toward the President’s goal to have K through 8th grade schools open five days a week.
And in the final piece of good news: To help meet our goal of ensuring Americans have a vaccine site within five miles of where they live, and to advance equitable distribution of the vaccine, we’re announcing today that we are expanding our community health center vaccine program so that the nearly 1,400 community health centers can sign up to receive and administer doses to their patients.  Many community health centers are located in underserved communities and serve patients that are predominantly either uninsured or underinsured.
As of today, more than 108 million Americans have gotten at least their first shot. And our vaccination program is progressing ahead of schedule, due to the aggressive steps we’ve taken at the President’s direction, to increase vaccine supply, the number of vaccinators in the field, and the places for Americans to get vaccinated, as well, of course, as the strong work of our partners.
But as the President also underscored, even as we vaccinate Americans in record numbers, we’re still not even halfway there.  And the progress we have made can be reversed if we let our guard down.  
Better days are on the horizon.  We do believe a more normal Fourth of July holiday is within reach.  But that’s nearly three months away.  And as the President said, “The real question is: How much death, disease, and misery are we going to see between now and then?”
So, before I turn to Dr. Walensky, let me just close by reminding Americans: It is in our power to minimize death, disease, and misery.  If we — if all of us do our part, we can help save lives in April, May, and June.
Wear a mask.  Socially distance.  Get vaccinated when it’s your turn.
And now over to Dr. Walensky.
DR. WALENSKY:  Thank you, Andy.  And good morning, everyone.  I’m glad to be back with you today.  As always, I’ll begin with an overview of the data.  CDC’s most recent data show that the seven-day average of new cases is a little more than 63,000 cases per day.  This is up approximately 2.3 percent compared to the prior seven-day average.  Hospital admissions also continue to increase.  The most recent seven-day average — about 5,000 admissions per day — is up about 2.7 percent from the prior seven-day average.  And deaths decreased 19.7 percent to a seven-day average of 745 per day.
Vaccinations continue to increase, with the most recent seven-day average of nearly 3 million vaccinations delivered daily, up 8 percent from the prior seven-day period. 
While these rates of vaccination are incredible and so encouraging for all of us, trends are increasing in both case numbers and hospitalizations.  Across the country, we are hearing reports of clusters of cases associated with daycare centers and youth sports.  Hospitals are seeing more and more younger adults — those in their 30s and 40s — admitted with severe disease.  Data suggests this is all happening as we are seeing increasing prevalence of SARS-CoV-2 variants, with 52 jurisdictions now reporting cases of variants of concern.
Based on our most recent estimates from CDC surveillance, the B117 variant is now the most common lineage circulating in the United States.  Testing remains an important strategy to rapidly identify and isolate infectious individuals, including those with variants of concern. 
These trends are pointing to two clear truths.  One, the virus still has hold on us — infecting people and putting them in harm’s way — and we need to remain vigilant.  And, two, we need to continue to accelerate our vaccination efforts and to take the individual responsibility to get vaccinated when we can. 
We have to recognize the high risk of infection in areas of high community transmission.  I encourage communities to consider adjustments to meet their unique needs and circumstances.  For example, in areas of substantial or high community transmission, CDC guidance specifically suggests refraining from youth sports that are not outside and cannot be conducted at least six feet apart.  Similarly, large events should also be deferred. 
We have guidance on CDC’s website on how to host small events safely, recognizing that our goals are to decrease transmission of COVID-19 and, importantly, to keep schools open and students engaged in in-person learning. 
To this end, I’m pleased to report that an important mitigation strategy –- educating — educator vaccination — was rolled out in the month of March, and it worked.  As the President announced yesterday and Andy reiterated: By the end of March, 80 percent of all teachers, school staff, and childcare workers across this country had received at least one dose of a COVID-19 vaccine.  That’s nearly 8 million people educating our children and working in our schools who have some protection against the virus. 
And we must continue to vaccinate as many Americans as we can each day because when we invest in vaccination and other public health prevention measures, we are seeing case counts decrease and deaths decrease.  This is the case in older adults, where over 55 percent of adults over 65 and older are fully vaccinated, protecting those that we — were so vulnerable a year ago when this pandemic began.
The trends in increasing cases and transmission also underscore the importance of President Biden’s announcement that all U.S. adults will be eligible to receive a vaccination by April 19th.
We are vaccinating, on average, 3 million Americans every single day — getting shots into arms, providing protection.  I urge everyone who has not received a COVID-19 vaccine to roll up their sleeves and join the nearly 108 million people who have already received at least one dose. 
I want to close by acknowledging the two important truths of this moment: There is still reason for us to be concerned with rising case counts, rising variants reported, and increasing hospitalizations — and there is so much reason for so much hope. 
Thank you.  I’ll now turn things over to Dr. Fauci.
DR. FAUCI:  Thank you very much, Dr. Walensky.  What I’d like to do over the next couple of minutes is to just talk a bit about the duration of immunity.
If I could have that first slide.
I’m going to break it up into two components: the duration of immunity to natural infection and the duration following vaccination. 
Next slide. 
With regard to natural infection, we now have a considerable amount of information related to the duration of what we hope we’ll be able to delineate more confidently — namely, what’s called the “correlate of immunity.”  In other words, what are the things that protect you against reinfection both from natural infection as well as the first infection following vaccination. 
Next slide. 
This is a paper from Science, from a couple of months ago, which looked at the multiple immune memory responses, including both antibodies CD4 and CD8 T cells following natural infection.  And about 95 percent of the subjects in this study — which was done by a group of immunologists, including Sean [sic] Crotty — Shane Crotty and Alex Sette, and they went out to six months after infection.  I want people to realize that that’s at least six months.  They did not look further than this, so it might be much longer.
Next slide.
And here’s an example from another study in which it was looked after both mild and severe episodes of COVID-19.  On the right-hand part of the slide, the darker blue line is the neutralizing antibody level following hospitalization.  The lighter blue line is the level following mild or asymptomatic infection.  And if you look at it, it peaks up at around 30 days but then gets a nice level, which is maintained out to beyond 180 days. 
Next slide.
Let’s look now at the important post-vaccination durability of immunity.
Next slide.
One representative study, which came out yesterday in the New England Journal of Medicine, looked at the persistence of responses through six months following the Moderna vaccine.  But there’s every reason to believe that similar results will be seen with the Pfizer, as well as the J&J.  If you look at this, antibody activity remained high in all age groups out to 209 days to three serological assays.  And I’ll explain in a second what they are.
Next slide.
If you look at this slide — just follow it going from the left to the right — notice that you have here, looking purely at binding antibodies, all age groups from 18 to beyond 71 years of age peaked up.  On the bottom of the slide, you’ll see the second arrow at 29 days.  It peaked up and stayed up well beyond the 209 days. 
Next slide.
If you look at pseudovirus neutralization, which is just an assay that does not look at the live virus, but that’s, sort of, a virus that has been built up to resemble the appropriate virus — this is a very striking slide.  Take a look at the left-hand part of the slide at the level of this neutralization.  Then look at day 29, where you get the boost.  Look at the sharp inflection of the level of neutralizing antibodies, which again go out to beyond 209 days.
Next slide.
If you look at the neutralization of the live virus, you see the same thing.  Look at the second arrow, following the boost at 29 days: a very sharp inflection, well above a protective level that goes out well beyond 209 days.
And on the final slide, the conclusion that although we are still working out the precise correlate of immunity, antibodies delivered by vaccination persist at least through six months, and likely, from the shape of the curve, well beyond that.
In that regard, ongoing studies are monitoring these immune responses beyond six months, as well as determining the effect of a booster dose to extend the duration and breadth of activity against not only wild type, but also emerging viral variants.
Back to you, Andy. 
ACTING ADMINISTRATOR SLAVITT:  Thank you.  All right.  Let’s take questions.
MODERATOR:  Let’s go to Anjalee Khemlani at Yahoo Finance.
Q    Thank you all, and thanks for taking the questions.  I know that in this time last year, we were looking at acceptable daily case counts.  And with California looking to open up more regularly by June, I wondered if we have a new number to include vaccinations on what it would — what the new threshold might be for reopening broadly.
ACTING ADMINISTRATOR SLAVITT:  Well, why don’t we start with Dr. Walensky, and if you would like to add something, Dr. Fauci, you can add after that.
DR. WALENSKY:  Thank you for that question.  You know, I think Dr. Fauci, over the summer, had been talking about case counts below 10,000, below 5,000.  We’re at 62,000 today.  So, you know, what I would say is, in the context of vaccination, we still need to have our case counts be really low to stop circulating virus, to stop the emergence of variants, to stop hospitalizations, and ultimately, to stop deaths. 
I’m really encouraged by these decreased numbers of deaths that I believe to be an impact of vaccination, especially the vaccination of our elderly communities.  But I think we’re way too high to be thinking that we’ve won this race.
ACTING ADMINISTRATOR SLAVITT:  And, Dr. Fauci, anything you’d add to that?
DR. FAUCI:  No, no.  Very well said.  It’s the — going to be the question of the case counts.  What we will almost certainly see as we get more and more proportion of the population vaccinated, that those case count numbers will come down.  But we would not recommend doing anything different until we get well below the level where we are right now.
Next question.
MODERATOR:  Kristen Shamus at the Detroit Free Press.
Q    Thanks for taking my question.  Michigan’s COVID-19 case rate leads the nation, and this surge is filling hospitals here once again.  Is there a plan on the federal level to push more vaccines to Michigan and other states nationally that are once again fighting a sharply rising COVID-19 curve?
ACTING ADMINISTRATOR SLAVITT:  Well let’s — let’s talk about what we’re doing in Michigan.  And, Dr. Walensky, since you’ve got a team on the ground there, maybe you can kick that off. 
DR. WALENSKY:  Yeah, thank you so much for that question.  We are working closely with the state of Michigan and the state health officials there.  We have CDC teams on the ground working to assess outbreaks in correctional facilities.  We’re working to facilitate increased testing that is happening on the ground in the context of youth sports.  We’re doing more surveillance and sequencing so we can understand what is happening with B117 and the –- and variants. 
And we’re working with the state to try and encourage that areas that have increased amount of outbreaks that we can really see are — the state is surging vaccines apply to those areas. 
ACTING ADMINISTRATOR SLAVITT:  Yeah, just — just to follow the rest of that question and emphasize some things that Dr. Walensky said: We have, within the state, the ability to move vaccine around, of course, but we’re in close contact — both through the CDC and direct conversations with the governor and her team — around what are the resources that could be most helpful at this point in time, as we do with other governors that find themselves in this situation. 
And, you know, nothing is off the table in those conversations in terms of the kind of support that we can provide.  And we’ll keep all options open as we — as we stay close. 
But there are really a menu — I want to leave you with the impression that there is not one tool, there are a menu of things — including staff, personnel, therapeutics, locations, and other kinds of things — that we review with states in this kind of situation. 
Next question. 
MODERATOR:  Let’s go to Jonathan Cohn at the Huffington Post.
Q    Hi, thanks for taking my question.  Actually, I have something of a follow-up on that — because I also happen to be based in Michigan, where the numbers are looking really scary. 
I’m wondering — and this is for Dr. Walensky, I think.  You mentioned in your statement that it might be time to, sort of, have some clearer guidance on after-school activities — you know, maybe staying out of indoor sports.  I’m wondering: Should states like Michigan, where the numbers are peaking — should there be stronger guidance?  I mean, should we be looking at a pause — you know, a short — some, you know — should there be a pause in restaurants?  In — more — should there be — or at least guidance to sort of stay out of indoor dining? 
Should that be coming from the state?  Should the CDC — and does the CDC have any plans?  Or is — are you considering stronger guidance that, you know, when the numbers are spiking like they are, especially with the possibility of vaccines — you know, we’re in this race and feels like we’re close but we’re falling behind.  So I’m just wondering if there should be more aggressive guidance than we’re seeing from either the state or federal officials.
DR. WALESNKY:  Yeah, as I mentioned, we’ve been in close touch with the state.  Our guidance on youth sports is actually pretty — pretty articulate with regard to having substantial or high transmission and that these activities should be happening outdoors and more than six feet apart.  In the — in the context of that, testing should happen at least twice a week if these are high-risk sports. 
So we’re pretty — we’re pretty clear on that guidance.  And we’ve been working with the state.  And I would advocate for, sort of, stronger mitigation strategies, as you note, to, sort of, decrease the community activity, ensure mask wearing.  And we’re working closely with the state to try and work through — towards that.
MODERATOR:  We’ll go to Kaitlan Collins at CNN.
Q    Thank you very much.  I had two questions.  One for you, Dr. Walensky, just to follow up on something you just said.  I think you said that the UK variant is now the most common lineages — lineage in the U.S.  Do you mean it’s the most common variant or it’s the most common, period — like, even compared with the original strain?
And then, I think this question probably is best for you, Andy.  Sorry, just one quick.  Yesterday, the President said we’re not at the finish line yet, but can you kind of clarify or qualify what does the finish line look like?  What should people be looking for to know that we are approaching that?  Since we know we’re not at it now, what does that look like?
DR. WALENSKY:  So, I’ll start.  Kaitlan, thank you for that.  It is the most common lineage, period.  So there are many different lineages of the — many different potential variants.  There are several different kinds of, sort of, wild-type variants, and this is, in fact, the most common lineage right now.
ACTING ADMINISTRATOR SLAVITT:  I think your second question, let me begin on, and then I would invite both Drs. Walensky and Fauci to comment.
You know, we’re at about three quarters of seniors that have had their first dose.  We think that can go higher.  And again, as the President did yesterday, we urge seniors and people who are in contact with seniors to help them get vaccinated right now.
We are in, you know, between 40 and 45 percent of adults in the U.S. that have had their first vaccine, which means sometime likely this month, over the next couple of weeks, we’re going to get to about half.
What’s important to remember, for those who are getting vaccinated, is that that still means that we’ve got half of the adult population that will not have had their vaccine yet. 
And so while it is very tempting as we each get vaccinated to think about the things we can now do, we need to remember that when we’re at our best as a country, we bring everyone along.  We don’t just bring ourselves along as we get over the line, but we bring the whole country with us.  And so every — we’ve got to continue to do this together. 
You know, as for a quote, unquote “finish line,” you know, I’m not sure that that’s necessarily the correct metaphor for what we’re going to experience.  I think Dr. Walensky, I would offer, has been, you know, leading commentary through, kind of, gradual steps along the dial that we can do as a country to get back to our old lives.  And that began weeks ago with conversations around what I kind of refer to as “the hugging guidance” between grandparents and grandchildren who are not high risk, and is extended into travel and other types of things.
But let me turn it to Dr. Walensky and Dr. Fauci to describe what their view of the question.
DR. WALENSKY:  Yeah, you know, I think you’re right on, Andy.  You know, we are working to vaccinate more and more people.  As we do so, we’re seeing really encouraging trends that the vaccination is working.  We’re seeing demographics — age demographics — change that.  You know, hospitalizations are now not happening as often in older populations, and they’re happening now more often in younger populations.
That said, we’re still seeing older people hospitalized, and it’s the ones that have not yet been vaccinated.  We’re still hearing stories of, “You know, I got my vaccine yesterday, and today I have COVID.”
And so what we really want to do is just scale up that vaccination more and more and more so that we can be in a place where we have more vaccine out there, and less — more vaccinations out there, and really less disease circulating. 
Sixty-five thousand cases — that’s sixty-five thousand opportunities for mutations to occur, for more variants to spread.  And so we’re just watching this very carefully.
ACTING ADMINISTRATOR SLAVITT:  Great.  Any reflections, Dr. Fauci, on that question?
DR. FAUCI:  Yeah, I mean, there’s not going to be an absolute number.  But I think what we’re going to see, Kaitlan, is that, as we get more and more people vaccinated, you’re going to see a concomitant diminution in the number of cases that we see every day and, with that, you know, the cascading domino effect of less hospitalizations and less deaths.
I don’t think it’s going to be a precise number.  I don’t know what that number is.  I can’t say it’s going to be “this” percent.  But we’ll know it when we see it.  It’ll be obvious as the numbers come down rather dramatically.
And when they do, we’re going to wind up getting really, stepwise, much, much more towards what we consider approaching a degree of normality, which everyone really quite dramatically notices it.
It’s on the way.  Hang in there. 
MODERATOR:  Last question.  Let’s go to Lev Facher at STAT News.
Q    Hey, everyone.  Thanks for this.  So another question on Michigan and vaccine allocation: Is it accurate to say that, as of today, the overriding or even the sole factor in determining state-by-state allocation is still population? 
And, I guess, if — given what’s going on in Michigan and the fact that there’s, at this point, frankly, excess supply, it seems like, in other states — you know, if not now, is there a time when you would consider tweaking that formula or even, you know, targeting specifically the J&J vaccines?  Just really any change in approach to respond to the urgency of the situation there.
ACTING ADMINISTRATOR SLAVITT:  Thanks for the question.  It’s a smart question because, you know, clearly there are phases that we will go through over time with this virus.  And so to answer the question generally, we have a long way to go today to get the country to a place where each of our states has reached the number of vaccinations that the population can handle. 
So, by and large, today, we are still — not entirely, but by and large, we are still have allocating vaccines based upon population until we get to that point.  Clearly, we will get to a place where — where targeted strategies will work.  But right now, I would commit to you that we’re doing both. 
And I’ll give you an example: Community health centers are now able to — will now be able to order vaccines for their communities directly.  Retail pharmacies — we are locating, surgically, in places that have had the greatest disease and have people with greatest exposure, largely in underserved communities.  We’re locating our federal vaccination sites in places where we think there’s the greatest need to fill. 
So I wouldn’t want to give the impression that we are someone who’s sitting back and managing this pandemic and the vaccination program according to some formula.  It’s not true in the least. 
We are getting the amount of vaccines we think are needed for the population because that’s fundamental.  And then we are working on very tactical areas on how to both maximize that — how to maximize that vaccine distribution so we get the things we want: efficiency, health equity, and the other goals that we have. 
So, it’s a — it’s a massive project.  It takes a lot of work, and a lot of very smart and good people are involved, and there’s a lot of dialogue with the states directly, as Dr. Walensky also indicated.
With that, I want to thank you for your attendance and your questions and we look forward to talking later in the week.
11:00 A.M. EDT

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